Thursday, January 06, 2022
Saturday, November 13, 2021
The Center for Medicare & Medicaid Services (CMS) published Medicare's 2022 costs on November 12, 2021.
I was not surprised by the increase amounts since there will be a 5.9% increase in Social Security on January 1st.
Sharing highlights of Medicare's Part B, covers all outpatient treatment and services, increases:
+ The monthly cost each person who is on Medicare pays will jump up $21.60 on January 1st to $170.10. It is $148.50 this year.
Note: Over 776,000 people with higher incomes pay more each month. There are five income based levels above $170.10, which is the base. The first step up is for individuals whose AGI on their IRS 1040 from two years ago is $91,000 or higher.
+ The annual deductible, which a person who is just using Part B would pay, jumps up $30 to $233 from $203 this year.
Highlights of Medicare's Part A, which covers hospitalization services and treatments, coverage in 2022.
+ There is no monthly cost for 99% of people on Medicare had at least 40 quarters of Medicare covered employment.
+ There is a $1556 deductible each time a person is in the hospital if they are just using Part A.
Monday, October 04, 2021
Individuals using Medicare can change the plan they have, which works with what Medicare pays, once a year. The time is now and is called Medicare's Annual Election Period (AEP). You can look at options for next year starting October 1st but can not sigh up for a new plan until October 15th. The AEP continues to December 7th.
What can be done during the AEP? You can sign up for a different plan with your current:
+ Medicare Advantage Plan company or select a plan with a different company.
+ Stand-alone Prescription Drug Company or select a plan with a different company.
Here in New London County seven companies will offer 30 different Medicare Advantage plans for the 2022 plan year. If you now have original Medicare with a Prescription Drug Plan you can select from 21 different plans from eight companies.
Yes that's a lot of options however there is much more to this than just looking at monthly cost. What to do? - Call John C Parker [Google Voice # (860) 451-9793] to talk about your situation / interest.
You gain many advantages working with a professional health insurance advisor who understand and shares insights on how medical treatment works in New London County. Finding the best option in our area for your situation is very important. In addition, being certified with the seven Medicare Advantage Plan companies means we can review the details and consider all seven companies.
On the other hand calling a company you see or hear in an ad means you are just talking to someone from somewhere and just review plan details.
John C Parker, RHU, LTCP
Friday, October 09, 2020
Each Fall, Medicare offers Individuals, called beneficiaries, an opportunity to make changes in their plans which work with Medicare to process all treatment and services or to pay providers the part of treatment and services expenses Medicare doesn’t.
• Medicare calls these times to make a change or sign up periods, and the one taking place each Fall is the AEP. It currently is from Oct 15 to Dec 7.
• The AEP is for people enrolled in a Medicare Advantage (MA) plan and those with a stand-alone Prescription Drug Plan. Individuals in CT with a Medicare Supplement can make changes at any time.
My focus is to eliminate confusion people may have about Medicare and the Medicare Health Plans. Thus, as we approach this year's AEP, I want to share some factual information about enrollment periods. This page from my Medicare Health Plans site has factual information.
Regretfully TV commercials throughout the year lead people to think they can change whenever they want, which they cannot. Ads use misleading statements such as - call to learn about new benefits you can have.
Another confusing thing about the time to make changes each Fall is sometimes incorrectly called an Open Enrollment Period. (OEP) The OEP however is not in the Fall. It is the first part of the year. It’s for people who are not happy with their specific Medicare Advantage plan to make a change. Technically it is the MA OEP and available Jan 1 through Mar 31.
You gain a lot more when talking with a health insurance advisor about all your options vs someone from one company!
John C Parker, RHU, LTCP
Thursday, September 24, 2020
Political ads and talking heads say - ACA is great - need to make it better! Really! Much of what is reported on the ACA is not correct Working with Individuals and small employers I can list many issues. However, instead, I am sharing some research on what the health reform regulations in the ACA did.
The research was reported in a Sept 23rd Forbes article. You can find all the details here.
The Galan Institute created a summary of the article. I am sharing two parts of it here between [snip]. I added bold to emphasize some of the Galan text.
Blase notes that despite spending $50 billion in taxpayer money on premium subsidies, individual market enrollment is up by just 2 million people from pre-ACA levels—a staggering $25,000 tab per newly insured. Exchange enrollment is 60 percent below expectations given how unattractive the products are to middle-income families.
"Calling the law ‘The Medicaid Expansion Act’ seems more appropriate
than ever since 100 percent of the net reduction in the uninsured has
occurred because of Medicaid. A massive expansion of Medicaid—a welfare
program that traditionally served low-income children, pregnant women,
seniors, and individuals with disabilities—is not what the ACA’s
proponents talked about when selling the law to the American people."
Fortunately, the policies of President Trump reversed some of this damage. Blase discusses actions to shore up the exchanges as well as expand more affordable options through Association Health Plans (AHPs) and short-term plans.
A Council of Economic Advisers report found that these expanded options, along with eliminating the individual mandate tax penalty, generate $45 billion in net economic benefit each year for Americans.
And the Trump administration’s health reimbursement arrangement (HRA) rule, which allows employers to offer tax-free payments that workers can use to purchase individual market coverage, is expected to add 8 million people to the market—four times as many as the ACA with no new federal spending.
While the Trump administration made great strides to help Americans harmed by the ACA, Blase argues that “A better approach would be freeing people to purchase coverage that best meets their needs and budgets, allowing states to establish safety net programs to ensure people with pressing health care needs receive the care they need, and transitioning as much government assistance as possible directly to consumers rather than funneled to health insurers.”
Want to specifically refer to certain words from the Galan summary - "as well as expand more affordable options through Association Health Plans (AHPs) and short-term plans. "
This refers to a federal program created to allow states to implement two ways to help individuals. Guess what! - CT decided individuals here in CT can not take advantage of these programs to save - they were not approved.
John C Parker, RHU, LTCP
Tuesday, August 18, 2020
People report being confused when online looking for — when can I sign up for MediCare and when does it start! That’s understandable since online info. is often “not quite accurate”! Thus, my post is to answer the “when can” and “when does” questions and review two special words used in signing up.
The first word in MediCare’s eligibility & signing up regulations to review is — “eligible.” Social Security (SS) manages eligibility regulations and CMS manages coverage details. These regulations, which I call “rules”, define eligible as a month not a specific date and it’s the month a person becomes 65. If a person does decide to apply at 65 they have what’s called an Initial Eligibility Period (IEP) to complete an application.
The IEP is seven months, with their eligible month in the middle, and they can — complete an application:
● Any month before eligible. If they do, both Part A & Part B start the first day of their eligible month.
Note: Eligible month is moved to the previous one when a birthdate is the 1st.
● During their eligible month or any month after. If they do:
+ Part A continues at the first of their eligible month.
+ Part B will be different! Why? “Rules” say it starts the:
- Next month if a person signs up the month when 65.
- Second month after if sign up the month after 65.
- Third month after if sign up either the second or third month after 65.
Signing up in the IEP’s last month — means Part B is six months after A. Having effective dates, other than the first of the next month, is confusing. To further complicate this SS decided — Part A will also be backdated six months from the date of a person’s Part B for — everyone who signs up six months or more after eligible! Do not know the logic of why this is done.
Note: Going back six months means a person with a HSA has to stop making contributions six months before leaving employment and starting Part B.
The second word in the eligibility “rules” to review is — "entitled". MediCare applies this term to everyone who has completed signing up. Entitled therefore is the date a person’s coverage begins for:
+ Part A’s inpatient hospital services and
+ Part B’s medically necessary outpatient services.
BTW — we know entitled is important because MediCare puts it on a person’s ID card! It’s printed above Part A and Part B to show when each coverage started.
Bottom line – when talking to individuals I use the official words. MediCare refers to individuals as beneficiaries and I believe it’s important for new and current beneficiaries to hear correct names even though people often read or hear other words, such as:
+ entitlement date instead of eligible
+ enrolled instead of entitled
John C Parker, RHU, LTCP
Saturday, July 25, 2020
Saturday, June 13, 2020
People tell me they are confused about what they found on MediCare. This is certainly understandable because when you Google signing up you find:
• Explanations using incorrect words for something. For example, Social Security enrollment rules and words from Medicare do not say enroll.
• Points on what to do and when are not correct.
• Information from a long time ago about – people need to/must sign up when they turn 65. Deciding when to sign up is the responsibility of each person/
Because of incorrect information like this and others and questions I hear it is important for people to know what to do and when.
Thus, I am pleased to share — factual information about the sign-up rules on this link It's from one page on my Medicare Health Plans web site.
John C Parker, LTCP. RHU
Saturday, May 30, 2020
Signing up for Medicare Part B after working past 65 is somewhat complex but it is now a little easier!
Individuals signing up for Medicare, whether at 65 or later after working past 65, do this through the Social Security (SS) system. There is an application for Part B (outpatient services) to complete, which also activates Part A (hospitalization situations). When working after 65 Part A is backdated six months from the date assigned to Part B.
Individuals working past 65 have another form to complete. They take it to their employer, dates covered by the company medical plan are listed, it is signed, and return to the SS office. This form gives them a Special Enrollment Period to sign up for Part B and avoids paying a late enrollment fee. SS offices have been closed so this process has been complex.
Pleased to report SS announced May 28th a way for a person, leaving an employer plan and wanting to sign up for Medicare, to complete the forms online. Information about this, the steps to be completed, and a link to begin to apply can be found here.
Friday, May 01, 2020
Monday, March 09, 2020
What might be a solution – wishful thinking? – work on the problem?
Saturday, January 04, 2020
One of the things which happen to many of us as “time goes on” is the potential to develop health problems increases!
Tuesday, December 24, 2019
Let’s now look at how to sign up. An Individual can: